Psychosis

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What are the symptoms?
Who gets psychosis?
What types of psychotic illnesses are there?
What causes psychosis?
How is psychosis treated?
Recovering from psychosis
Where to go for help

What is psychosis?

Psychosis describes a group of symptoms that affect the mind, where there is loss of contact with reality. A psychotic episode is when a person becomes ill in this way. There are different signs that appear when someone may be on the verge of a psychotic episode, such as social withdrawal, a decline in normal functioning, depression or anxiety, decreased concentration, sleep disturbance, and difficulty handling everyday stresses or pressures.

What are the Symptoms?

What are the symptoms?

Positive symptoms

Changes in thoughts and feelings added to a person’s experiences, such as paranoia or hearing voices.

Delusions are firmly held false beliefs that are not consistent with a person’s culture. They are unique to the individual experiencing them and may be difficult for others to understand.

Hallucinations are sensations that aren’t really there an can affect all five senses. For example, the person might hear voices or sounds that no one else can hear, which is the most common hallucination. They may also smell things no one else does, or hear music. These experiences appear very real to the person experiencing them and they may respond to voices out loud.

If a person is having a psychotic episode, they may behave differently from the way they usually do. They may be extremely active or lethargic. Often changes in behaviour are associated with the other symptoms of psychosis.

Disorganised speech or behaviour may include the inability to relate to a conversation or responding with unrelated answers. It may also mean the inability to hold conversation or drifting from one topic to another. Disorganised behaviour include: actions that do not fit the situation, such as wearing inappropriate clothing based on weather or other circumstances; difficulty with tasks, including self-care and hygiene; or inappropriate emotional responses, such as laughing at a tragedy or harmful situations.

Negative symptoms

These symptoms may be less evident to identify but may involve a decrease or loss of normal functions. Negative symptoms include: lack of emotion or expression; monotone speech or limited responses, such as one word replies; difficulty thinking; lack of motivation; inability to feel pleasure from things that previously were enjoyable; or lack of interest in other people.

Who gets psychosis?

Who gets psychosis?

Approximately 3% of the population will experience a psychotic episode at some point in life. It occurs in all cultures and societies in both men and women. The first episode will generally occur in adolescence, generally between 18-24 years of age. It is good to remember that symptoms of psychosis are treatable.

What types of psychotic illnesses are there?

What types of psychotic illnesses are there?

Each person’s experience of psychosis is different. This can make it very difficult to make a clear diagnosis, particularly during a person’s first episode of psychosis. Many mental health professionals do not use a diagnosis but refer to it as ‘an episode of psychosis’ or ‘first episode psychosis.’
Some people may only have one episode of psychosis and not experience it again.However, when a person has experienced a number of episodes of psychosis they may be given one of the following diagnoses:

Schizophrenia

A group of mental illnesses that affect a person’s ability to think, feel and act. The symptoms may include hallucinations, thought disorder, delusions, withdrawal, loss of emotion and energy, and inappropriate emotions. To be diagnosed with schizophrenia, symptoms must have been continuing for a period of at least six months.

Bipolar disorder

Affects the way a person feels. You may experience periods of very extreme moods – feeling very high and/or very low for days, weeks or months. You may have delusions or hallucinations which are consistent with the high or low mood. Some people have a series of manic episodes, others a series of depressive episodes, while others have both manic and depressed episodes.

Schizoaffective disorder

There are two subtypes of this disorder (bipolar and depressive). In Schizoaffective Disorder, people have symptoms of either Schizophrenia and Bipolar, or Schizophrenia and depression.

Schizophreniform disorder

Schizophreniform disorder is diagnosed if the psychotic symptoms last more than one month but less than six months. Symptoms are similar to those of schizophrenia.

Drug-induced psychosis

Drug-induced psychosis occurs as a result of someone, who is predisposed to a psychotic episode, using drugs. With drug-induced psychosis, the symptoms appear quickly and last a relatively short time, from hours to days, until the effects of the drug wear off. Disorientation, memory problems and visual hallucinations are the most common symptoms.

Delusional disorder

Someone with delusional disorder may hold strong beliefs in things that are not true. They may have delusions of being persecuted, that people are out to get them, or that they are someone famous.

Major depression

Someone with major depression can have a type of depression which is so intense it causes loss of interest and enjoyment, loss of appetite, severe insomnia and even psychotic symptoms such as delusions.

Post-partum psychosis

Hormonal changes after childbirth can bring about post-partum psychosis, which often resembles Schizophrenia or bipolar disorder. Post-partum psychosis happens to about 1 in 500 pregnant women and usually occurs in the first 6-8 weeks after the birth.

Other illnesses

Other physical illnesses altogether can affect the brain and cause psychotic symptoms. Some of these illnesses include AIDS, thyroid disorder, Dementia, brain tumour, Huntington’s Disease and viral infection.

What causes psychosis?

What causes psychosis?

Current research suggests a combination of biological, psychological, social and cultural factors can trigger psychosis. Symptoms of psychosis often emerge in response to stress, drug abuse or social/environmental changes. They are more common in an individual whose capacity to cope with these stressors is overwhelmed.
There is some evidence that a combination of biological factors can create a vulnerability to experiencing psychotic symptoms during adolescence or early adult life.

Genetic

For some psychotic disorders, there is no family link at all. For others, such as Schizophrenia and Bipolar Disorder, evidence suggests that genetic factors may play a part.

Stress and trauma

Stress and trauma are experiences which undermine our sense of safety or survival. Such experiences can overwhelm the person’s ability to cope. Many different situations can cause an individual trauma and effect their coping mechanisms. A traumatic event, particularly from childhood trauma, may trigger psychosis however not all trauma leads to psychosis.

How is psychosis treated?

How is Psychosis Treated?

The first phase of treatment involves assessment. This involves having a series of interviews with mental health specialists. Physical tests are needed to exclude a physical cause for the symptoms. Information obtained from the person, family and friends, together with the test results, will provide some idea about the type of psychosis being experienced, the cause, and how it may be treated.

Medication

Medication plays a fundamental role in medical treatment for a psychotic episode and in the prevention of further episodes. Different types of medication are effective in reducing the symptoms of psychosis and the anxiety these symptoms can cause.

Counselling and psychological therapy

Having someone to talk to is an important part of treatment. As recovery progresses, there are practical ways to learn to prevent further episodes. These can include stress management techniques or ways of recognising warning signs. Counselling for the individual and their family can also be very important. Support groups may provide some of the necessary support for recovery.

Hospital

Sometimes there are benefits in spending a period of time in hospital before continuing with home treatment. Hospitalisation allows symptoms to be observed more closely and medication to be trialled and stabilised.

Social support

Support from family and friends is crucial as it reduces isolation and makes it easier to cope with the symptoms. Community support and the reduction of discrimination and myths surrounding psychosis also has a great impact. Other forms of support which may be helpful for recovery include: safe and supportive housing, support in gaining employment; income support from Centrelink during periods of illness; and training through TAFE or universities.

Recovering from psychosis

Recovering from psychosis

Recovery may take many forms. It is a unique and personal journey of reclaiming a sense of self, and wellbeing after a period of distress. From a medical perspective, recovery is the absence of active symptoms or disorder. The pattern of recovery from psychosis varies from person to person and can be influenced by a wide range of factors. Some people recover quickly with very little intervention. Others may benefit from support over a longer period.

Where to go for help

Where to go for help

In an emergency Please call 000

Mental Health Line 1800 011 511 - 24 hour service across NSW

Headspace

for young people 12-25 years

Schizophrenia Fellowship of NSW

(02) 9879 2600

Royal College of Psychiatrists

Mental Health Carers NSW
(02) 9332 0700
1800 655 198

SANE Australia
1800 688 382

WayAhead Information Services

wayaheaddirectory.org.au

WayAhead Mental Health Support Line - Mon-Fri, 9am-5pm

1300 794 991

WayAhead Anxiety Disorders Support Line - Mon-Fri, 9am-5pm

1300 794 992

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Disclaimer

This information is for educational purposes. As neither brochures nor websites can diagnose people it is always important to obtain professional advice and/or help when needed.

This information may be reproduced with an acknowledgement to WayAhead – Mental Health Association.

The Association encourages feedback and welcomes comments about the information provided.